Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

2018 ◽  
Vol 37 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Simon Nennstiel ◽  
Matthias Treiber ◽  
Alexander Faber ◽  
Bernhard Haller ◽  
Stefan von Delius ◽  
...  
Keyword(s):  
Success Rate ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Standard Technique ◽  
Biliary System ◽  
Complication Rates ◽  
Success Rates ◽  
Major Complications ◽  
The Right ◽  
Transhepatic Biliary Drainage

Background: Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the palliation of an endoscopically inaccessible biliary system. Since a standard technique of PTBD is not defined, we compared a fluoroscopically guided technique (F-PTBD) with an ultrasound (US-PTBD) guided approach. Patients and Methods: Procedure characteristics, success-rates and complication-rates of the different PTBD techniques were compared in patients who underwent PTBD between October 1, 2006, and ­December 31, 2014. Results: In 195 patients, 251 PTBDs (207 F-PTBDs, 44 US-PTBDs) were performed. F-PTBDs were mostly inserted from the right and US-PTBDs from the left. Patient age, gender and physical status were comparable in both techniques. There was no difference regarding overall procedure success (90%/86.4%), overall interventional complication rates (10.6%/9.1%), fluoroscopy times, intervention times or sedatives dosages. However, major complications were only encountered in F-PTBDs. There was a higher success rate for F-PTBD vs. US-PTBD from the right side (91.9 vs. 75%; p = 0.033) and a trend towards a higher success rate for US guidance from the left side (82.9 vs. 95.8%; p = 0.223). Conclusions: For drainage of the right biliary system F-PTBD seems superior over the US-PTBD technique used in this study. However, major complications can occur more frequently in F-PTBD.

Reduced complication rates of percutaneous transhepatic biliary drainage with ultrasound guidance

2017 ◽  
Vol 45 (7) ◽  
pp. 400-407 ◽  
Author(s):  
Andrej Wagner ◽  
Christian Mayr ◽  
Tobias Kiesslich ◽  
Frieder Berr ◽  
Paul Friesenbichler ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Ultrasound Guidance ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Complication Rates ◽  
Transhepatic Biliary Drainage

scholarly journals Complications of left and right sided percutaneous transhepatic biliary drainage

2019 ◽  
Vol 6 (4) ◽  
pp. 1281
Author(s):  
Suhail Rafiq ◽  
Azhar Khan ◽  
Jan Suhail ◽  
Nasir Choh ◽  
Feroze Shaheen
Keyword(s):  
Biliary Drainage ◽  
Bile Ducts ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Liver Parenchyma ◽  
Minor Complication ◽  
Malignant Obstruction ◽  
Palliative Procedure ◽  
Major Complications ◽  
Left And Right ◽  
Transhepatic Biliary Drainage

Background: Percutaneous Transhepatic Biliary Drainage (PTBD) is performed either via right or left-ductal approach, on the basis of status of primary confluence, secondary confluence and atrophy of liver parenchyma. Our study compares the complications of two approaches in malignant obstruction. The objectives of this study was to assess and compare complications of PTBD.Methods: This study was a prospective hospital based study performed for a period of 2 years from 2016 to 2018.PTBD was performed either via right in 16 patients or left-ductal approach in 15 patients, on the basis of status of primary biliary confluence and atrophy of liver parenchyma.Results: Both minor and major complications were more common in right-sided approach as compared to left-sided approach with most common major and minor complication being cholangitis (16.12%) and fever (12.9%) respectively.Conclusions: PTBD is an excellent palliative procedure to drain the bile ducts in malignant obstruction. Although complications of PTBD are more common in right sided approach but results are statistically insignificant.

Outcome and Complications of Percutaneous Transhepatic Biliary Drainage: Influence of Liver Entry Site

2021 ◽  
Vol 15 (10) ◽  
pp. 3140-3142
Author(s):  
Vicky Kumar ◽  
Amjad Sattar ◽  
Nauman Al Qamari ◽  
Hatem Adel ◽  
Muneer Sadiq
Keyword(s):  
Success Rate ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Guide Wire ◽  
Total Bilirubin Level ◽  
Left Lobe ◽  
Biliary Duct ◽  
Entry Site ◽  
Right Lobe ◽  
Transhepatic Biliary Drainage

Objective: To determine the outcome and complications of percutaneous transhepatic biliary drainage (PTBD) performed via right lobe and left lobe duct puncture. Study Design: Cross-sectional study. Place and Duration of Study: Department of Interventional Radiology, Dow Institute of Radiology, Dow University of Health Sciences from July 2020 to March 2021. Methodology: Both adult male and female patients with obstructive jaundice having dilated intrahepatic biliary ducts on ultrasound were included. PTBD was performed under ultrasound guidance. Following intrahepatic biliary duct puncture, a guide wire was inserted followed by placement of 8 Fr or 10 Fr pigtail drainage catheter. Total bilirubin level was measured before and one day after the procedure. Cholangiogram was performed 48 hours after the procedure to check the drain placement and residual dilatation. Results: 130 patients were included with mean age of 55.3 ± 12.3 years. Success rate was same in patients with right and left lobe puncture i.e. 96.9%. The frequency of complication in right lobe puncture was higher (37.5%). Mean procedure time was significantly higher in patients who developed complications (75.92 ± 19.20 minutes) as well as mean exposure time was also significantly higher in patients who developed complications (12.00 ± 6.87 minutes) as compared to patients who did not develop any complication (8.08 ± 3.43 minutes) (p <0.05). Conclusion: It was concluded that the success rate in right and left lobe puncture was equal and complication rate in right lobe puncture was observed to be high as compared to left lobe puncture. Keywords: Biliary drainage, Complications, Effect, Liver

scholarly journals Percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts: technical considerations and complications

2020 ◽  
Author(s):  
Federico Pedersoli ◽  
Anja Schröder ◽  
Markus Zimmermann ◽  
Maximilian Schulze-Hagen ◽  
Sebastian Keil ◽  
...  
Keyword(s):  
Contrast Media ◽  
Biliary Drainage ◽  
Bile Ducts ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Statistical Significance ◽  
Fluoroscopy Time ◽  
Bleeding Complications ◽  
Complication Rates ◽  
Technical Data ◽  
Transhepatic Biliary Drainage

Abstract Objectives The aim of this study was to compare success, technical complexity, and complication rates of percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts. Methods In a retrospective analysis, we evaluated all consecutive PTBD performed in our department over a period of 5 years. Technical success, technical data (side, fluoroscopy time, radiation dose, amount of contrast media, use of disposable equipment), procedure-related complications and peri-interventional mortality were compared for patients with dilated vs. non-dilated bile ducts. Independent t test and χ2 test were used to evaluate the statistical significance. Results A total of 253 procedures were performed on 187 patients, of whom 101/253 had dilated bile ducts and 152/253 not. In total, 243/253 procedures were successful. PTBD was significantly more often successful in patients with dilated vs. nondilated bile ducts (150/153 vs. 93/101; p 0.02). Overall complication rate (13%) did not differ significantly between patients with dilated vs. nondilated bile ducts. Procedures in patients with normal, nondilated bile ducts were associated with a significantly higher rate of post-interventional bleeding (5/101 vs. 0/152). Mean fluoroscopy time (42:36 ± 35:39 h vs. 30:28 ± 25:10 h; p 0.002) and amount of contrast media (66 ± 40 ml vs. 52 ± 24 ml; p 0.07) or use of disposables were significantly higher in patients with nondilated ducts. A significantly lower fluoroscopy time and amount of contrast medium were used in left hepatic PTBD. Conclusion Despite the higher technical complexity, PTBD with nondilated bile ducts was associated with similar overall complication rates but higher bleeding complications compared with PTBD with dilated bile ducts. Key Points • PTBD was associated with similar overall complication rates in patients with dilated vs. nondilated bile ducts. • Although overall complication rates were low, PTBD in patients with nondilated bile ducts was associated with a higher incidence of post-interventional bleeding. • PTBD in patients with nondilated bile ducts is technically more complex.

Conversion of external percutaneous transhepatic biliary drainage to endoscopic ultrasound-guided hepaticogastrostomy after failed standard internal stenting for malignant biliary obstruction

Endoscopy ◽  
2017 ◽  
Vol 49 (06) ◽  
pp. 544-548 ◽  
Author(s):  
Woo Paik ◽  
Nah Lee ◽  
Yousuke Nakai ◽  
Hiroyuki Isayama ◽  
Dongwook Oh ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Clinical Success ◽  
Stent Migration ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Stent Patency ◽  
Transhepatic Biliary Drainage

Abstract Background and study aim Percutaneous transhepatic biliary drainage (PTBD) is a rescue procedure after a failed endoscopic retrograde cholangiopancreatography. As PTBD causes patient discomfort, conversion of the PTBD to internal biliary stenting (PTBDS) may be required; however, PTBDS is sometimes difficult because of the tight stricture. We evaluated the efficacy and safety of conversion of external PTBD to endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) after failed PTBDS. Patients and methods A total of 16 patients with malignant distal biliary obstruction who underwent conversion of external PTBD to EUS-HGS after failed PTBDS were enrolled from two institutions in Korea and Japan. Data were analyzed retrospectively. Results The technical and clinical success rates were 100 % and 81 %, respectively. Early adverse events developed in two patients: proximal stent migration (n = 1), and cholecystitis (n = 1). Stents were occluded or migrated distally in five patients. The mean duration of stent patency was 402 days. Conclusions Conversion of external PTBD to EUS-HGS may be a good rescue option after failed PTBDS.

Hyperalimentation of jaundiced patients on percutaneous transhepatic biliary drainage

1986 ◽  
Vol 73 (9) ◽  
pp. 716-719 ◽  
Author(s):  
D. Foschi ◽  
G. Cavagna ◽  
F. Callioni ◽  
E. Morandi ◽  
V. Rovati
Keyword(s):  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Transhepatic Biliary Drainage
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